A framework for engaging physicians in quality and safety

Taitz, Jonny; Lee, Thomas H.; Sequist, Thomas D.

doi:10.1136/bmjqs-2011-000167

Cited by 115 publications

(103 citation statements)

References 14 publications

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“…Second, the lack of physician participation in the local safety projects described in our study has been identified as a key barrier to interprofessional collaboration by several authors 6 15 27. The lack of physician participation has been linked to the hierarchies and tensions that continue to exist between professional roles within interprofessional contexts 6 10 27–29.…”

Section: Discussionmentioning

confidence: 86%

Implementing an interprofessional patient safety learning initiative: insights from participants, project leads and steering committee members

et al. 2013

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Section: Discussionmentioning

confidence: 86%

Implementing an interprofessional patient safety learning initiative: insights from participants, project leads and steering committee members

et al. 2013

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“…39,40 Healthcare organisations should be seeking to learn from one another, especially those whose performances are at the healthier end of the scale, as well as from studies into how to advance clinical involvement in improvement efforts. 41 They should also be linking clinical governance and leadership to quality-improvement activities. As noted elsewhere, such linkage can elicit important gains, particularly around increasing health professional commitment to quality and safety improvement.…”

Section: Discussionmentioning

confidence: 99%

Healthcare professional perspectives on quality and safety in New Zealand public hospitals: findings from a national survey

Gauld

Horsburgh

2014

Aust. Health Review

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Background. Few studies have sought to measure health professional perceptions of quality and safety across an entire system of public hospitals. Therefore, three questions that gauge different aspects of quality and safety were included in a national New Zealand survey of clinical governance.Methods. Three previously used questions were adapted. A total of 41 040 registered health professionals employed in District Health Boards were invited to participate in an online survey. Analyses were performed using the R statistical environment. Proportional odds mixed models were used to quantify associations between demographic variables and responses on five-point scales. Relationships between other questions in the survey and the three quality and safety questions were quantified with the Pearson correlation coefficient.Results. A 25% response rate delivered 10 303 surveys. Fifty-seven percent of respondents (95% CI: 56-58%) agreed that health professionals in their District Health Board worked together as a team; 70% respondents (95% CI: 69-70%) agreed that health professionals involved patients and families in efforts to improve patient care; and 69% (95% CI: 68-70%) agreed that it was easy to speak up in their clinical area if they perceived a problem with patient care. Correlations showed links between perceptions of stronger clinical leadership and performances on the three questions, as well as with other survey items. The proportional mixed model also revealed response differences by respondent characteristics.Conclusions. The findings suggest positive commitment to quality and safety among New Zealand health professionals and their employers, albeit with variations by district, profession, gender and age, but also scope for improvement. The study also contributes to the literature indicating that clinical leadership is an important contributor to quality improvement.What is known about the topic? Various studies have explored aspects of healthcare quality and safety, generally within a hospital or group of hospitals, using a lengthy tool such as the 'safety climate survey'. What does this paper add? We used a simple three-question survey approach (derived from existing measures) to measuring healthcare professionals' perceptions of quality and safety in New Zealand's public hospitals. In doing so, we also collected the first such information on this. What are the implications for practitioners? New Zealand policy makers and health professionals can take some comfort in our findings, but also note that there is considerable scope for improvement. Our finding that more positive perceptions of quality and safety were related to perceptions of stronger clinical leadership adds to the international literature indicating the importance of this. Policy makers and hospital managers should support strong clinical leadership.

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“…We examined these questions from the perspectives of educators who have led and implemented a PIM in training, as there is increasing recognition of the need for physician leadership in quality and patient safety 8 and emerging evidence that physician leadership contributes to successful QI project implementation. 9 …”

Section: Introductionmentioning

confidence: 99%

Optimizing the Implementation of Practice Improvement Modules in Training: Lessons from Educators

Bernabeo¹,

Hood²,

Iobst³

et al. 2013

Journal of Graduate Medical Education

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Background The American Board of Internal Medicine approved the use of Practice Improvement Modules (PIMs) to help training programs teach and assess practice-based learning and improvement (PBLI) and systems-based practice (SBP). Methods We surveyed individuals who ordered a PIM in a residency or fellowship training program between June 2006 and August 2009. The 43 programs that volunteered to participate completed a 30-minute anonymous online survey. Results Program directors or associate program directors led the PIM process in 30 programs (70%). Trainees' degrees of involvement in PIMs were highly variable between programs, and several respondents felt that trainees were either not sufficiently engaged or not engaged with enough consistency. The most common activity for trainee involvement was data collection through patient surveys or chart review, although only 17 programs (40%) provided protected time for this activity. Few trainees participated in higher level activities such as data analysis or identification for areas of improvement or were given leadership roles; yet most respondents reported that completing the PIM helped trainees learn basic principles of QI and develop competence in PBLI and SBP and that PIM completion improved the program's ability to develop QI initiatives and resulted in program or institutional improvements, including sustainable improvement in patient care. Most respondents reported that the outcome warranted the effort to complete PIMs. Conclusions PIMs may be a valuable but underused educational experience for trainees as well as training programs. Focusing on particular themes and facets of PIMs may facilitate implementation.

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A framework for engaging physicians in quality and safety

Cited by 115 publications

References 14 publications

Implementing an interprofessional patient safety learning initiative: insights from participants, project leads and steering committee members

Implementing an interprofessional patient safety learning initiative: insights from participants, project leads and steering committee members

Healthcare professional perspectives on quality and safety in New Zealand public hospitals: findings from a national survey

Optimizing the Implementation of Practice Improvement Modules in Training: Lessons from Educators

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